In this prospective, real-world cohort study nested within a national screening program for tuberculosis, Lesley Scott and colleagues compare the performance of Xpert MTB/RIF on single sputum sample with different TB detection technologies.

Improved access to anti-retroviral therapy increases the need for affordable monitoring using assays such as CD4 and/or viral load in resource-limited settings. Barriers accessing treatment, high rates of loss initiation and poor retention care are prompting find alternatives conventional centralized laboratory testing certain countries. Strong advocacy has led a rapidly expanding repertoire point-of-care tests HIV. is not without its challenges: regulatory control, lack guidelines, absence...

In South Africa, health care workers (HCWs) are at two-fold greater risk of acquiring tuberculosis (TB) disease than the general population. Few studies have evaluated incident tuberculous infection.To determine incidence and factors for latent infection (LTBI) among HCWs to compare results interferon-gamma release assay (IGRA) with those tuberculin skin test (TST).HCWs, including medical students, underwent a TST human immunodeficiency virus (HIV) IGRA testing baseline 12 months, 6 months....

Background Expansion of HIV viral load (VL) testing services are required to meet increased targets for monitoring patients on antiretroviral treatment. South Africa currently tests >4million VLs per annum in 16 highly centralised, automated high-throughput laboratories. The Xpert HIV-1 VL assay (Cepheid) was evaluated against in-country predicates, the Roche Cobas Taqmanv2 and Abbott HIV-1RT, investigate options expanding using GeneXpert's random access, polyvalent capabilities already...

Point-of-care (POC) HIV viral load (VL) testing offers the potential to reduce turnaround times for antiretroviral therapy monitoring, offer near-patient acute diagnosis in adults, extend existing centralized VL services, screen women labor, and prompt pediatrics early treatment. The Liat Quant plasma whole-blood assays, prerelease version, were evaluated South Africa. precision, accuracy, linearity, agreement of assays compared those reference technologies (Roche CAP CTMv2.0 Abbott RealTime...

Human immunodeficiency virus self-testing (HIVST) reduces barriers associated with facility-based testing; however, no formal mechanism exists for users to self-report results or link care. The AspectTM HIVST mobile application (app) was developed use in South Africa.This study evaluated the acceptability and feasibility of app individuals from inner city Johannesburg.This cross-sectional pilot, a convenience sample 300 adults, conducted July 2018. Participants were provided an OraQuick kit...

Implementation of Xpert MTB/RIF requires quality assessment. A pilot program using dried culture spots (DCSs) inactivated Mycobacterium tuberculosis is described. Of 274 DCS results received, 2.19% generated errors; the remainder yielded 100% correct detection. The probe cycle threshold (C(T)) variability three batches was ≤ 3.47. study longer-term stability ongoing.

Lack of accessible laboratory infrastructure limits HIV antiretroviral therapy (ART) initiation, monitoring, and retention in many resource-limited settings. Point-of-care testing (POCT) is advocated as a mechanism to overcome these limitations. We executed pragmatic, prospective, randomized, controlled trial comparing the impact POCT vs. standard care (SOC) on treatment initiation care.Selected POC technologies were embedded at 3 primary health clinics South Africa. Confirmed HIV-positive...

Point of Care testing (POCT) provides on-site, rapid, accessible results. With current South African anti-retroviral treatment guidelines, up to 4 fingersticks /patient/clinic visit could be required if utilizing POC. We determined the feasibility and accuracy a nurse performing multiple POCT on followed by simplification process performance POC single fingerstick.Random HIV positive adult patients presenting at clinic in Africa, for ART initiation/ monitoring, were approached participate...

A plethora of point-of-care (POC) tests exist in the HIV and tuberculosis diagnostic pipeline which require rigorous evaluation to ensure performance field. The accuracy feasibility nurse-operated multidisciplinary-POC testing for antiretroviral therapy (ART) initiation/monitoring was evaluated.Random HIV-positive adult patients presenting at 2 treatment clinics South Africa ART were consented enrolled. POCT performed by a dedicated nurse on venipuncture specimen; Pima (CD4), HemoCue...

ABSTRACT The Roche LightCycler mycobacterium detection molecular assay for Mycobacterium tuberculosis , M. avium and kansasii was applied to tissue specimens. It performed well on lymph node cerebrospinal fluid specimens less lung, liver, bone marrow core biopsy specimens, but used in conjunction with a clinical suspicion of tuberculosis, it could augment patient management.

The GeneXpertMTB/RIF (Cepheid, USA) (Xpert) has proved successful for pulmonary tuberculosis (TB) diagnosis on decontaminated/concentrated induced sputum specimens from children. Capacity to perform induction in many settings is limited.To assess: (i) volumes of 'routinely obtained' a district-level academic hospital; (ii) whether not meeting Xpert-required testing could still be tested; and (iii) performance Xpert single paediatric specimen at point care (POC).Two sputa were collected TB...

The use of dried culture spots (DCSs) has been reported in the verification GeneXpert instruments as being "fit for purpose" South African National implementation program. We investigated and compared performance DCSs across different bulk batches, testing settings cadre staff, Xpert MTB/RIF assay version. Four batches (V005 to V008) were used prepare (i) 619 DCS panels laboratory on G3 or G4 cartridges by a technologist, (ii) 13 (batch V005) clinic nurse lay counselor, (iii) 20 10 16 module...

The frequency of acute HIV infection (AHI) among HIV-1 enzyme-linked immunosorbent assay (ELISA)-negative samples received from general hospital patient admissions was assessed. Of 3,005 pooled for nucleic acid testing, a prevalence 0.13% found. Pooled testing may be feasible low-cost identification AHI in high-prevalence settings.

HIV-infected patients require antiretroviral treatment for life. To improve access to care, CD4 enumeration and viral load tests have been redesigned be used as point-of-care techniques using finger-stick blood. Accurate counting in capillary blood requires a free flowing drop that is achieved by blade incision. The aim of this study was assess the attitude toward blade-based donation.Four hundred ninety-nine were included (299 from South Africa 200 Belgium). They completed questionnaire...

Viral load (VL) quantification is an important tool in determining newly developed drug resistance or problems with adherence to antiretroviral therapy (ART) HIV-positive patients. VL monitoring becoming the standard of care many resource-limited settings. Testing settings may require sampling by fingerstick because general shortages skilled phlebotomists and expense venepuncture supplies their distribution.To assess feasibility ease collecting 150 µL capillary blood needed for use a novel...

Increased access to antiretroviral drugs expands needs for viral load (VL) testing. South Africa's National Health Laboratory Service responded demands by implementing two testing platforms in 17 laboratories within 8 months. An industry partner's collaboration, training programs, and method verification with a VL prequalification panel ensured quality rapid implementation.

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No abstract available.

Background A causal relationship exists between HBV infection and membranous nephropathy. The association is especially close in Black children sub-Saharan Africa. Interferon-α2b commonly used to treat this condition, but effective only 30–40% of patients. reason for the poor response unknown. objective study was determine if mutations surface gene isolated from with HBV-associated nephropathy before, during after interferon treatment, have any effect on treatment vice versa. Methods DNA...

Dried culture spots (DCS) of inactivated Mycobacteria strains designed as part an external quality assessment (EQA) program for the GeneXpert system has applications to other molecular tuberculosis (TB) diagnostic platforms. DCS tested on GenoType MTBDRplus and Mycobacterium CM assays performed well with version 2 but require increased bacterial concentration use 1.